This invention relates generally to surgical methods and apparatus and, more particularly, to apparatus for effecting closure of surgical incisions without using sutures, staples or other invasive devices.
In known sutureless surgical techniques, upon conclusion of the surgical procedure the opposed skin edges of the incision are re-approximated and then held in position by tape, laces, glue and the like, until healing is completed. For example, U.S. Pat. No. 2,752,921 to A. S. Fink entitled "Surgical Dressing for Closing Wounds", describes a wound closing system wherein two strips are adhered to the skin, after the incision is made, at opposite sides of the incision. The strips are drawn toward one another by laces coacting with opposed hooks secured to the strips and thereby close the wound. Being applied after the incision has been made, with no apparent means for aligning, the strips can provide little more than a crude re-approximation of the edges of the wound, which could lead to excessive scarring.
U.S. Pat. No. 4,966,605 to W. R. Thieler entitled "Method for Opening and Closing Surgical Wounds", describes a procedure in which an elastic member is adhered to the patient's body at the site of the intended incision, and the incision made by first cutting through the elastic member and then the patient's skin, and conducting the necessary surgical procedure. Following closure of the wound, the skin at opposite edges of the incision is re-approximated by bringing together the edges of the slitted elastic member and adhering a relatively inelastic sealing member to the elastic member to maintain the edges of the slit in the elastic member (and thus, the skin at the edges of the wound) together in abutting relationship while the wound heals. To accommodate the possibility that more than one attempt will be required to accurately re-approximate the skin at the prepped edges, a pressure-sensitive adhesive is used on the sealing member to enable it to be repeatedly removed and re-positioned.
Improper re-approximation of the skin at the edges of a surgical incision can interfere with healing and may lead to skin irregularities, excessive scarring and keloiding, i.e., formation of fibrous tumors arising from connective tissue of the skin. Among known attempts to match the cut edges of the skin during sutureless closing of an incision is that described in U.S. Pat. No. 4,976,726 to C. E. Haverstock entitled "Skin Closure Devices", wherein markings are applied to opposite sides of the intended incision for use in realigning the cut edges of the incision during closure to assure an abutting relationship. Proper alignment becomes more difficult as the length of the incision increases.
The above described sutureless techniques not only fail to provide accurate and rapid re-approximation of the cut edges of the skin but result, at best, in bringing the skin at opposite sides of the incision into an abutting relationship. However, for improved healing it is considered preferable that the opposed edges of the skin be brought sufficiently close together to cause the joined edges to evert, that is, turn outward slightly, an effect also known as "tenting", as opposed to bringing the edges into abutting relationship. This promotes blood flow through connecting tissue of the opposed edges of the incision resulting in accelerated healing and a thinner scar line because the skin is healed without tension. The described prior art sutureless surgery techniques fail to provide everting contact or "tenting" of the skin at the opposed edges of the incision.
Accordingly, a primary object of the present invention is to provide an improved system for effecting rapid and accurate closure of a surgical incision.
A more specific object of the invention is to provide a system of closure components for aligning and bringing the opposed edges of an incision together in an everted or "tented" relationship, without use of sutures, staples or other invasive devices.